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Permit CITY OF TIGARD ' PLUMBING PERMIT ri "! COMMUNITY DEVELOPMENT Permit #: PLM2009 -00072 Date Issued: 04/03/2009 T IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S101 D600103 Jurisdiction: Tigard Site address: 7360 SW HUNZIKER RD 105 Subdivision: Lot: 0 Project: Surplus Line Association of Oregon Project Description: TI, add (1) new lay. Owner: FEES HILLTOP BUSINESS CENTER LLC & Quantity Description Date Amount HUNZIKER LLC, 9430 NW KAISER RD 1 ea Lavatories 04/03/2009 $16.60 PORTLAND, OR 97231 1 12% State Surcharge - 04/03/2009 $8.70 PHONE: Plumbing 56 ea Minimum Fee Adjustment 04/03/2009 $55.90 Contractor: - Plumbing WESTERN PLUMBING 9460 SW TIGARD, AVE STE 101 TIGARD, OR 97223 PHONE: 503 - 639 -5296 FAX: 503- 684 -9015 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Stories: Total $81.20 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules Issued By: � v., Ln n kk Permittee Signature: ` Call 503.639.4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. , _14/02/2009 07 :59 5036849015 WESTERN PLUMBING INC PAGE 01/03 Plumbing Permit A lies CEl ® FOR ()I FILE �1Si.,,(�l\'LY_ Ci Bid Received DO 9 karmic No.: A �/ / p��! � � 13125 .25 SW W Hall 11 Dlvd., Tigard, OR 972 DD_- i n Phone: 503.639.4171 Fa 503.59p - 2 2009 Date/13y: Plat* Review / � Inspection Line: 103,639. hate/By OtherPermitN TI( AR D Internet: WWw,tlgard- or.gov TI GARD DateReady/By: _ Jura • 11'1 See m eia i or �, .,,, - Na - 11 '�., � � j ,� �� (z �' '^�'`"u� a "z ""` ' •""" " " a r � r -, my supplemental Information 1) % . ti zr. - : . c^ ;;74 7v r ' ` a yr',f 9 v : , y, ) .. 4z1, e - ,. 12:' � ' \ -.f .. _ ' ' r., �i �.Ya , -3.s :V'..�,w .� _ .,., Ada l e i I , ,,• sa , i) . 1,: , , '' rile , .. z . %r14;: ,.,' ', : , , i^ ',":; , >i� a '�_ „, : ; 1 :1 �,,. _.�,.. ,.., +<r t ,.;r,...c'i.... ? .fa �` u� .u, ?. � M� � I >>;iJ .... ,,..w , } ^:^. :s s .5 _r'-c �r� � a r,,.,., u � � r ,.,.,, .. �;, :a i ..,,..4 ?,,�.;� ,; 0 New construction 0 Demolition For s ecial In orma &on use checklist • �i� Addition/alteration/replacement © Oth er: Description qty. Ea. 7 Total ,. r ...... .. : ...... ,.r .:•:... New 1 - fared dwellings (includes 100 for r ,Y v w+ ,, l .rm Y 8 ( 00 ft. each utility conncctton cu r ' F , 2`' 1� ' p r r ritf e F ur2 'sr, ., h ^: I a,( 1 „•'. „ „ cc . ., , `;� z.w: rs t3' ) : ', � : \,,.. ,::4S . , ? „ 'rh.. ,, , s e...w aa, r ^:t1-7"'va,.�s:z,, e e .: yi ;w s ^ f 1 � „:NA.za ,, n, ' : : : :: c, >y .• ` ";", u q , ± : s c, ^ �, . • Sklt (1) barn 249.20 b ❑ 1 - and 2- family dwelling 11 CotranerciaUlndustrial SFR (2 bath 350.00 El Accessory building 0 Multi- family SFR ( 3) bath 399.00 Each additional bath/kitchen 43.00 ❑ Master builder El Other: r. 1 ,,.}..,,.. r, t . , ��° fi!;tr ::.. ......... = ;"' _ � _ . ; <;r; Fires rinlCler t, .. ,1- pp -ii , ,., , . x•^ ,.ri.."'„o % . ry v, , ; ; :� P L- s }�.. r,inti, 4j, '43: 1rSgfuit'� , P �eF Tn ,I 'iH� Ml ",th ce 7 �"i t ; , 1N'%M .,. 4- ) Page2 I ,.�_�....' 1. r..... '1.,.M.::^ 2 i „ ',..i4f .F u, ^ . ,'�X f , ;1f1; ik .. Site Utilities •""-- , Job site address: ` - ` 1t ` � area drain 16.60 C / Catch basin or aity /State /ZIP: �L:ri�l��i! Drywell, leach line, or trench drain 16.60 . Suite /bldg. /apt. no.: Project name: 41 . Roaring drain (no. linear ft.: ) Page __ o 2 ��. A 1 n Cross street/directions to job ate: r�l r ��� r-1 Manufactured home utilities 110 00 � � a „�y Manholes 16.60 - Rain drain connector 16.60 Sanitary sewer (no. linear ft.: _) Page 2 Storm sewer (no. linear ft.: __) Page 2 Subdivision: Lot no.: Water service (no. linear ft.: ) Page 2 Tax map /pv ce1 n0.: ix y,...,.. / Fixture e o , .:; J;wit;.,.'r..4;1,1. :•, : 7.0;.~r?,,P, :,t0FM,2 O arc / ,,;:7. Abso do Item . :a : .-�,. ...,a,. : u,..,n, .. a : - :.t `,. :.,:,,,: . LIs,..: ,.. : :.)it .;;,;;,a- : ::....,,; .-, .. iA 1 0 16.60 ...,. : ut1,r . " , M:' : a >... :1:k. r 1 x '', 1 .Z; , 1 .n ., 1 J'ii " ;d ! 5 t' . Z. yl 2 t : S z e I ' r `M y � s l h.v ._..,r Ma M; :,.S v_.,., : <.k I . x .;?1,, BacWowpreventer Page Backwater valve - 16.60 �/i t� . „' j1 l Clothes washer 16.60 IIMI Dishwasher ME n -�� �i�^ � y ."`°we•�.. : :w� :amp. X� !''. : �. : :;.-: ^ :r :, ..�...",Yra :; ^ : : :.��,a�*"�.. � - .. : _...,� - ., 16.60 t r ei 1 t<rci t 4+f',r ` � 1 r5 .^�� I j ;tis,M. (( > ti 'r ^' , ,lu �.,, .,: } .az Drunkin fountain 16.60 I '.,�2:_,., ,)l, us: :• ;„ 1.. ,.Ick;: ,,r .. r.s '" 6 1 1'^ :.:';.,Y 1 '' } n x , C ""° �' "� K . 1 1 X21 ?' +� + r t i g r�_,. .caeca . r,«,.. :, . , ,- i,dt�,s. ............ , :.,._ ' . ' .,!.,.„,y > ., w . „ rC: : ., + Ai"?.,,,. :y„�u: Name: Fjee ors /sump 16.60 Address: ---- 16.60 Expansion tank Fixture/sewer cap I6.60 lel City/State/ZIP: Floor drain/floor sink/hub 16:60 .r Phone: ( ) Fax: ( ) Garbage disposal 16.60 , a., -., . ,- ,a� , �•• .,..... -.._ ::, : : +•.. il..i. . &1 , • . . ,,i.,,:... a x M: #�a .a ....r^,m_ ' 1 � 4 4'� � � I�09C bib 16. 60 t 3�w,t .... . vn» r:.::.,.. A.:;, n.. : :.1.4....::irl,.::.( #a - z ,.. . -tt. :...... * ( R :_< : : :r., : �� ^ 1.,,.�,1 ..�.,�. �... ., ....,... . :, ...,.,.. ,._. , , Ice make Business name: _ 16.60 • Contact name: Interceptor /grease trap 16.60 _ Medical gas (value: $ ) Page 2 m, Address: Primer 16.60 City /State/ZIP: r Roof drain (commercial) 16.60 Phone: ( ) .. Fax:: ( ) '"` Sinklbasin/iavatory 16,60 MN E Tub /shower /shower pan 16.60 �� • , Urinal iT, , E wl�i p rr t, T i .1^�•rw • r -�- e 16.60 l cr ' �t ' 1: 2 ;z: 'r V , rca , ' v, i ` 4z in , t (� � s c M } 7 „ ;, 4 ;4 „ ,..., :..svt ,� ..�.,...,, . �,>,. :, i„ +a....,,,..z. „m;.., a,c t,rrk,.:: n_<..,.„.t w .M.. � vm Water 16.60 Business name: Western Plumbing, Inc. Water heater 16.60 Address: 9460 SW Tigard Avenue, Suite 101 Other: �, - City/State/ZIP: Tigard, Oregon 97223 _ Subtotal - (503) 639 -5296 Minimum permit fee: $72.50 , Phone: r ( ) Fax: (503) 684 - 9015 Residential backtlow minimum permit fee: $36.25 CCB Lie.: 2439 _ Plumbing Lic. no.: 3429PB Plan review (25% of permit fee) Authorized si ature /.� State surcharge 12% of permit fee _ _ TOTAL PERMIT FEE K t :, Print name: Dana Jensen Date: _t t This permit application expires if a permit is not obtained within i1 180 days after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board, I: UP „ ird , nE „ r + •„y :r,A.pLM- rcrmnApp. doe 06,X/06 440 RI 0(02JCOM/w n) 3\03 ©C 04/02/2009 07:59 5036849015 WESTERN PLUMBING INC PAGE 02/03 Plumbing Permit Application, - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Su . 8 ression S stems: T.f" ., .,... {v Tt -.. 7nJ?c :r °:: �,a: 44.'t. .. ....arc,:T.: ::' ,.., : .�F:irx R31 ,• ,. . � r r Si3 c { ( � .r 7..,I l M- � +�G d , rw„ w.» �.�5,...,.ea °�--c °�, �, ef a""", "' " "'.'� ' G Sl r .� / t 4 , : J W , c i .i ! . . a:n�,:�ty .1', :4i i,j,?.,' 9 ii "Lk I " ,a 4, }r�,1. 4�, " #r, Q' � ,.t r". r :- ,;�. _.+,..a�,u. Yc�t 1 t ! 1 �;.:. R.,-.,.,., ��... ew,,,. �. �;' �" d�'.., r , r �x" x � yy "l° . , �kk� %,:;.i'w:B :..;r.£^'?:n ..��i,3 1.P: ...,......eT�v�'_km.,;r, �,,..�t.�..row,��ro�{�.,m, :.::,�.>_. x..: ,•�r4x,r�� Footing drain - 1" 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 Mill 2 001 to 3,600 $160.00 3 601 to 7 200 $220.00 Egil MI 1111M 55.00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 Water Service - 1st 100' 55.00 Mill Medical Gas S stems: Water Service - each additional 100' _ 46.40 °:-- ....T. " y, , �a ,_ ; _.. 9 .: -, Storm & Rain Drain - 1st 100' 55.00 N y x s .: ' i^ . n _ $1.00 to $5 000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 46.40' MN $5,001.00 to $10,000.00 $72.50 tvr the first $5,000.00 and $1.52 for cad) ar..::- z.: wrr::.-: a... 1;.' f.'/ a' r'..; 4�Ri !°i!:;f!:5�.v.Tx,.,:...:.:.: cwn .::;.;w. ,,,. u„-.-: ea.;; r. a::::.:.,:::: r..,•x;*,RFka:'M='r "s'scay -T;a! t::: °- •. ::: ......... . ° ..� ;i A ... � ,..�....�,,.._.,...... . ....,t , , .., ;: � ..,...,.. �_ n��.,.. additional $100.00 or fraction thereof to and .!t rl1 lr {k i✓ � .�..... ,� M....�.., - a, � �i, ,` %1_ ..,•: F._.•. r�; rs-,;:: r�:.,, �. t4, �,;>: ��. �c` hatir: �:: r`' �;:: �; �,« �•:: �,:: x:;;�;; � ::..............._., �s:.,:::::." �`:.__..........{., 5.. :.:....._.,..;...,..:.:.,:,,I including $10.000.00. Commercial Back Flow Prevention Device _ 46.40 MI $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1 54 for Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to minimum .omit fee $36.25 and including $25,000.00. Rain Dram, single family dwelling 65.25 $25,001.00 tq $50,000.00 $379,50 for the first $25,000.00 and $1.45 for Inspection of existing plumbing or each additional $100.00 or fraction thereof, to and including; $50,000.00. e aciall ie• Bested ins • ections - er hour $50,001.40 and up $742.00 for the first $50,000.00 and $1,20 for Subtotal: each additional $100.00 or fraction thereof • • Fixture W :... _.K. r,...... >< earl , r� � ... ..�: -: g to q .. rt.;.:;;:: � �,>„, yo„✓ � ......d'.�1::!....v ^ ?,.'::�v:: �..;. x5�^rx�m , . 7 ':. �: bt: Mt��a' rc�M li! Y:: �� ��4 ��r,': � i�. ...�����`:'r;'� { ti3iYFi$�iicrt ,. Are you capping, adding or replacing fixtures? If "yes ", Plan review is`required for any of the following, please indicate work performed by fixture. failure to PIease check all that apply. accurately ref ort fixtures could result in increased sewer fees * . ❑ Any now commercial building with water service 2" and ;s i;4l, li EAR i = ,„ w l.. - greater, except systems designed and stamped by licensed C� ,..�.,.r'� ,�,.;irrv�M` rt • � , tC7� .. -„ 1 r;it,:..:....� $ � Y .'V.c1Al1Gr {xn�: {'(:; �" :c. >�. .. :.,. +.j ?.: R..k:.,l,c, �. t:: d.. la: �',; ,tivGr,"1'�:,,.��',+ w: 1, �,,., a,; ,:.",ak.,r:WlL.t,�R�;c1R...,... r':'.;':tt' :.. OP :V. :s`lt .rx "� >..rTR ..,,�. { ,,,,.. ie.. „ �„'% " �a *2' °;; "�+� w'�,'��e o °;�� en ineer, g blitz i ,lour 1 Viii �.,fr:.._r�"s,�: RanikT. ; &lkt5w? 1.;.,.,,.a,'. . ,»r�"` ':,a1,S;au . ❑ Any new exterior plumbing situ utilities. 13 aptistry/Font . _ © Medical gas and vacuum systems for health care facilities Bath - Tub /Shower •❑ Any multipurpose fire sprinkler system. - Jacuzzi/Whirlpool • Cat" Wash Each Stall ❑ Any complex structure as defined in OAR918 -780 -0040. -Drive Thru Cuspidor/Water Aspirator Submit 2 sets of plans with any of the above. Dishwasher - Commercial - x :ry �¢aM•ru�„v ^•^^err -w� .,(w�,A, . 4,�,..::.xc.:r�:::.::xa:.rn ..... .... .... 1:: n.:::.-.e:• -,. -Domestic T n ' k R: ° .. Px . `+ e Y:'a' a '7 Qy ; g Drinking Fountain ... ",,.,..,.' °. Eye Wash - ❑ Isometric or riser diagram is required for new buildings Floor Drain /sink - 2" that meet the qualifications above. - 3" Comments regarding fixture work: • Car Wash Drain Garbage - Domestic Disposal - Commercial - Industrial Ice Mach./Refrig. Drains µN _ Oil Separator (Gas Station) . Rec. Vehicle Dump Station Shower -Gang -Stall *Note: If the fixture work under this permit results in an Sink - Bar /Lavatory increase of sewer EDUs, a sewer permit will be issued and - Bradley . fees assessed for the sewer increase must be paid before the - Commercial plumbing permit can be issued. - Service _ Swimming Fool Filter Washer - Clothes Water Extractor Water Closet - Toilet Urinal Other Fixtures I: V°EIK- rerrn(Levp,dpc 05 06